VA Pension Should Not Impede Medicaid Eligibility

Veteran's Aid & Attendance Income Should Not Impede Medicaid Eligibility

 If you, your spouse or your parent have recently qualified for a VA Improved Pension (VAIP) read about pension benefits and are also applying for or receiving Medicaid assistance you need to know your rights. 

A portion of the benefit may represent Aid & Attendance (A&A) which under the federal and Florida Medicaid rules is not countable income.  Veterans or their spouses who need the aid and assistance of another individual and who have limited assets and limited income (which can be reduced by showing payment of unreimbursable medical expenses) may be eligible to receive benefits.  'Unreimbursable medical expenses' (UMEs) are not paid for by insurance.  They can include:

1.    co-pays

2.    deductibles

3.     rent at an assisted living facility

4.    the cost of a home health aide

5.    adult garments

6.    over-the-counter (non-prescriptive) supplies or vitamins

7.    therapies (i.e. acupuncture); and much more. 

 Why is this so important? Without proper documentation from the Veteran's Administration (VA) learn more, the Department of Children & Families (DCF) may improperly tell you that you have too much income to qualify for Medicaid unless you agree to create a qualified income trust (QIT) and transfer the pension into the trust.  Do not assume that DCF is correct - it can cost you time, money and loss of your Medicaid benefits and your room at the assisted living facility.

Florida is one of a few states that impose a monthly gross income limit in order to qualify for Medicaid assistance.  Currently, the monthly gross income limit is $2,163.00 for an individual. Click here to learn more 'Gross income' includes sources such as: Social Security retirement; Social Security Disability Income; I.R.A. distribution; 401(k) distribution; pensions from employment.  If an applicant's monthly gross income exceeds the limit, that person will not qualify for Medicaid unless an attorney prepares a QIT and it is properly funded each month (with the amount of income exceeding the state limit).  There is a fee for an attorney to prepare the QIT.  Why spend money if you don't have to? 

It is important that you advocate for having the VA issue a letter stating what portion of the check represents reimbursement for medical expenses.  The portion of the payment that represents unreimbursed medical expenses (UME) is not countable income. That letter must then be submitted to DCF as proof that your income or your loved one's income is below the Medicaid monthly income limit.  If you do not obtain a letter detailing the breakdown between the different VA programs then DCF will assume that the full amount of the check is countable income and decide that you do not qualify for Medicaid.

 If you find yourself running into a road block call our firm to assist you.  We will be happy to advocate on your behalf with the VA and DCF. 

We want to be your trusted advisor through life.

PET TRUSTS

                          Your Beloved Pet Deserves a Pet Trust

Recently, more people are including their pets in their estate plan.  In 2012 a Tennessee resident died and provided for the future care of his two casts in his Last Will & Testament.  He has left $250,000.00 and his home to Frisco and Jake. The monies that remain after Frisco, the older cat, dies will be distributed to his family provided that they care for the remaining feline. Click here to read more.

Many clients have shared with me how their lives have been more meaningful by sharing their home with a pet.  It is only fitting to plan for the future of your pets after you have left this earth.  Florida and other states have laws that permit pet trusts. A pet trust can be created in your Last Will & Testament or your Revocable Trust.  Consider these preparation tips before you meet with your elder law attorney:

 

1. Identify all your intended beneficiaries (people, animals and charities).

 

2. Determine what assets and how much you would like to leave to each beneficiary. It is generally best to work with percentages and not dollar amounts. No one has a crystal ball to predict what assets will remain at your demise.  Using percentages assures that each beneficiary will receive something.

 

3. Think about whether you want your pets and other beneficiaries to receive assets at the same time or, if your priority is the animals first and then distribute remaining assets to individuals and/or charities.

 

4. Identify a trusted person or organization to care for your pets.

 

5. Create a rough estimate of the yearly cost of care for your pets.

Once you have prepared, meet with a qualified elder law attorney and create a plan that will make the aging process easier for you and provide for the comfort and care of your loved ones.  Our firm is here to guide you. We want to be your trusted planning advisor through life.sm

LONG TERM CARE PLANNING: DIVORCE IS NOT YOUR FIRST OPTION

A hotly contested issue in the Florida Legislature this month concerns spousal refusal.  'Spousal refusal' is both a federal and state law that enables a married person to obtain Medicaid assistance when one spouse refuses to make their assets available to the spouse who requires long-term care.  The person applying for Medicaid must sign a form that assigns their right to support from their spouse to the state. 

 A bill was sponsored that sought to give the Department of Children & Families (DCF) the ability to deny Medicaid for anyone that did not cooperate in DCF obtaining a court order of medical support against the spouse.  The proposed bill was more restrictive than federal law which is not permitted. Thanks to an active group of Florida elder law attorneys it appears that the bill is not going to pass.  DCF will be required to publish proposed rules and hold public hearings which will allow elder law attorneys and the public to comment and have an impact on whether a proposed rule is adopted (rather than DCF trying to influence lawmakers).

In Florida, a spouse is not legally responsible for the debts of the other spouse.  Several years ago, the Florida Supreme Court made this ruling in a case where a hospital sued a patient's wife for payment of the husband's unpaid hospital bill.  Our Supreme Court ruled that the wife could not be held responsible for her husband's debts.  DCF is trying to get around the law.

Sadly, DCF may be leading the Florida Legislature to put married couples in a position where they feel their only option is to get a legal divorce so that their assets cannot be viewed or deemed available to their ill spouse. With increasing life expectancies more people are concerned about how they will pay for their own daily living and long-term care once their spouse becomes ill.  The amount of assets that the well spouse can keep is not realistic in light of the cost of living and the cost of medical care. In addition, some couples are in second or third marriages and specifically keep their wealth separate to pass onto their respective families (many have pre-nuptial agreements). The option of spousal refusal is necessary and should not be taken away. Illness and mortality, for many people, cause fear to rise to the surface.  The last thing we need is our government to take away spousal refusal.  What we need is respect for the institution of marriage and to help people finance the cost of long-term care.